Having a Colonoscopy Patient Information - Endoscopy Department - Portsmouth Hospitals NHS Trust
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Endoscopy Department
Having a Colonoscopy
Patient Information
Specialist Support
This leaflet can be made available in another
language, large print or another format. Please speak
to the Ward Manager who can advise you.It is important that you read this leaflet before 1 We will need a list of all the medications
that you are currently taking. Please bring this
attending your pre- clerking appointment. 2 medication list with you to your
3 pre-clerking appointment.
What is a Colonoscopy?
A colonoscopy is a procedure that allows us to look at the
PLEASE NOTE: that iron tablets will need to be stopped
lining of your large bowel (colon). In order to do this, a thin
7 days prior to your procedure date.
flexible tube called an endoscope is passed through your anus
(back passage).
Why should I have a colonoscopy?
Biopsies (small samples) can be taken if required and sent to Your doctor / specialist has recommended that you have a
the laboratory to be looked at under the microscope. The colonoscopy to find out the cause of your symptoms or to help
biopsies taken are about the size of a match head and will to diagnose and monitor long term conditions such as:
not cause you any pain. Photographs / recordings may also be • Inflammatory bowel disease (Colitis / Crohn’s)
taken and kept on your records.
• Infection
?
• Polyps
?
How can I prepare for my colonoscopy?
We will arrange a pre-clerking appointment • Diverticular disease
before your colonoscopy. At this time, a
nurse will check your general health, and
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explain the procedure to you. This is the What are polyps?
time you can ask any questions you have.
A polyp is a protrusion (bulge) from the lining of the bowel.
They are usually removed by the Endoscopist as some may
The pre clerking nurse will administer the bowel preparation,
grow and become cancerous over time. There are a variety of
give advice on what to expect and how to take it. The bowel
ways to remove polyps depending on where they are in the
preparation is a medication that clears your bowel by causing
bowel and their size. Removing polyps is a painless procedure.
diarrhoea. You will not be able to eat while taking the
medication. Your pre-clerking nurse will discuss this with you in
more detail.
2 3Will I be asleep for the procedure? • Not to have the procedure. If you decide to not have
No. A colonoscopy is usually performed using conscious this procedure then a potential abnormality may be
sedation and pain relief if required. The sedation may make missed. You are advised to speak to your doctor before
you slightly drowsy and relaxed. You are NOT unconscious making this decision.
during the procedure and you will be able to talk and follow
instructions. Sedation sometimes has an amnesic effect, What are the risks?
A colonoscopy is generally a very safe KNOW
meaning you don’t remember the full procedure after it has THE RISKS
happened. procedure. Complications are rare. If a polyp
is removed, the risks are slightly increased.
You will be given additional oxygen,
small prongs which sit in your nostrils. • Perforation
There is a small risk of making a tear in the lining of
PLEASE NOTE: after having sedation, you are not able to your bowel. You may also need further treatment such as
drive a vehicle, drink alcohol, operate any machinery, return antibiotics and / or surgery. In very rare cases, surgery may
to work or sign any legally binding documents lead to a stoma (an opening is made on your tummy to
for 24 hours following your procedure. You DRIVING divert faeces into a bag).
will also need a responsible adult to collect OR
you from the Endoscopy Unit, drive you ALCOHOL
for 24 hours • Bleeding
home and stay with you for 24 hours. This usually stops on its own. In rare cases where significant
bleeding occurs treatment and / or a blood transfusion may
Gas and Air (Entonox) can be offered during your procedure. be required.
This can help to relax and relieve discomfort. The benefit of
using only Entonox is that you will be back to your normal self • Adverse reaction to the medications
and able to drive within half an hour. Sedation can occasionally cause problems with breathing,
heart rate and blood pressure. If any of these problems do
Are there any alternatives? occur they are usually short lived.
• CT (computerised tomography) scan - This is a special type
of X-ray (also known as a ‘Virtual Colonoscopy’). It has the • Missed pathology
disadvantage that biopsies / polyps can not be removed. Every effort is made to complete the procedure as
These samples may be vital for diagnosis, meaning you thoroughly as possible but it is accepted that small polyps
may still need to have a further colonoscopy. CT scans are may be missed.
generally considered less accurate than a colonoscopy and
involve radiation.
4 5• Incomplete procedure You will then be asked to change into
On rare occasions, an incomplete procedure can occur for a hospital gown. We recommend that
reasons such as; you bring with you a dressing gown
- a technical difficulty and slippers for your comfort while
- stool or blockage in the colon you wait to have your colonoscopy.
- difficulties during the procedure
- significant discomfort It is our aim for you to be seen as close to your arrival time as
possible. However the Endoscopy Unit is very busy and your
Giving my consent (permission) procedure may be delayed due to emergencies.
You will need to give consent to go ahead with the procedure.
It is important that you are fully informed about all aspects Please expect to be in the Unit for 2 - 5 hours.
of the procedure and understand the risks and benefits for
consent to be valid. What happens during the procedure?
You will have the opportunity to ask any final questions that
There is a copy of the consent form printed in this booklet for you may have, while the Endoscopist asks you about the
you to read through (found on pages 10 & 11). If you have any symptoms you have / the reason for the procedure.
questions or concerns, or want to talk about giving consent or
any part of the procedure, this can be done at the time of your A small cannula / tube is inserted into a vein in your arm
pre-clerking. Your consent form will be completed with the or hand and you will be given the sedative and pain relief
pre-clerking nurse. through this. A small probe will be put on your finger to
D
monitor your oxygen levels and heart rate. We will also
What happens when I come for my colonoscopy? monitor your blood pressure.
LEVEL You will report to our reception desk at the
endoscopy unit on D Level. The admitting You will be asked to lie on your left side on a trolley (bed).
nurse will in turn take you to a private room to However you may be asked to change your position during the
complete the admission process. Your consent procedure. A nurse will remain with you throughout.
will be confirmed at this point as well as
checking your bowel preparation has worked The Endoscopist will firstly lubricate your anus with some
ENDOSCOPY jelly and will then gently insert a finger into the rectum. The
and that your observations are satisfactory.
UNIT
Endoscopist will then insert the endoscope.
6 7Medical air will be pumped into the bowel to enable the will be available in 2 weeks. Your GP will also receive a copy.
Endoscopist to see. This can sometimes cause some discomfort/ It is normal to have mild abdominal discomfort following a
bloating. It is advised that you pass this air as required to colonoscopy. This is due to the medical air that is inserted
relieve discomfort throughout the procedure. during the procedure but this should settle within a few hours.
There are some naturally occurring bends in the bowel and • You can eat and drink normally straight after your
when passing these, it may become uncomfortable for a short procedure.
period but the sedation and pain relief will help to minimise
this. • You may have loose motions for a day or two following
the procedure. This is due to the bowel preparation you
The procedure usually takes between 20 – 60 minutes. have taken. There is a possibility you may also become
mildly constipated.
PLEASE NOTE: if your procedure is performed by a trainee
Endoscopist, they will be under the close supervision of an General points to remember
experienced Endoscopist. It is our aim for you to be seen as close to your appointment
time as possible. However we are also a busy unit which also
What happens after my colonoscopy? looks after emergencies and some times your appointment may
You will be taken to the recovery area. A nurse will check your be delayed.
observations and monitor you for around 30 minutes. You
will be offered something to eat and drink before leaving the The hospital cannot accept any responsibility for the loss
department unless the Endoscopist has specifically asked for a or damage to personal property during your time on these
fasting period. premises.
?
?
If you have had sedation, you must have a responsible adult to What if I have more questions?
collect you from the Endoscopy Unit, to drive you home and to If you have any questions regarding your
stay with you for 12 hours after the procedure. appointment please contact the
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Endoscopy Unit at Queen Alexandra
Before you leave the department, the nurse or doctor will Hospital on 02392 286000 ex 5798.
explain the findings of your procedure to you, and give you
basic after care advice. Routine biopsies and polyps that have If you have any urgent medical questions then please call
been sent to the laboratory can take up to 8 weeks to be 02392 286000 ex 5798 to speak to an experienced nurse.
processed. The Endoscopist will write to you with the results. Otherwise, make a note of your questions and the nurse can
If an urgent result is required, the results are fast tracked and answer them when you come for your pre-clerking.
8 9Statement of patient of patient
Statement
ConsentConsent
Form 1 Form 1
Patient identification label
Patient identification label
Patient Agreement to Investigation
Patient Agreement or Treatment
to Investigation or Treatment
Patient details (or pre-printed
Patient label)
details (or pre-printed label)
NHS Organisation NHS ............................................... Patient’s first names
Organisation ............................................... ..............................................................
Patient’s first names ..............................................................
Please read thisPlease
form read
carefully. If your
this form treatment
carefully. has treatment
If your been planned
has in advance,
been planned youin advance, you
Surname / familySurname
name ...................................... Responsible health
/ family name ...................................... professional
Responsible health ........................................... should alreadyshould
professional ........................................... have your ownhave
already copy,your
which
owndescribes the benefits
copy, which describesand
therisks of theand risks of the
benefits
Date of birth ....................................................... Job title ..................................................................................
Date of birth ....................................................... proposed treatment.
Job title .................................................................................. proposedIf not, you willIfbenot,
treatment. offered a copy
you will now. If you
be offered have
a copy now.anyIffurther
you have any further
NHS number (or NHSother number
identifier)(or ............................ Special requirements
other identifier) ............................ Special.............................................................
questions, do ask
requirements .............................................................
- we aredo
questions, here
askto help
- we you.
are hereYouto have the right
help you. to change
You have yourtomind
the right change your mind
at any time, including afterincluding
at any time, you haveafter
signed this
you form.
have signed this form.
Male Male Female (egFemale
other language (eg
/ other communication
other method)
language / other communication method)
Name of proposed
Name ofprocedure
proposedor course ofor
procedure treatment
course of treatment I agree to the procedure or course
I agree to the of treatment
procedure or coursedescribed on this
of treatment form. on this form.
described
(include brief explanation if medical
(include brief term not
explanation clear) term not clear)
if medical
I understand that you cannot
I understand give
that mecannot
you a guarantee that
give me a particular
a guarantee person
that will
a particular person will
Colonoscopy +/- Polypectomy
Colonoscopy +/- Polypectomy perform the procedure. Theprocedure.
perform the person willThe
however,
personhave appropriate
will however, haveexperience.
appropriate experience.
Statement of health professional
Statement of health professional
(to be filled in (to
by health professional
be filled with
in by health professional with I understand that I will havethat
the Iopportunity toopportunity
discuss the details of anaesthesia with
I understand will have the to discuss the details of anaesthesia with
appropriate knowledge of proposed
appropriate knowledgeprocedure,
of proposedas specified
procedure,in consent policy)
as specified in consent policy) an anaesthetistanbefore the procedure, unless the urgency ofthe
my urgency
situationofprevents this. prevents this.
anaesthetist before the procedure, unless my situation
I have explained the procedure
I have to the
explained the patient.to
procedure In the
particular,
patient.I have explained:
In particular, I have explained: (This only applies toonly
(This patients having
applies generalhaving
to patients or regional anaesthesia.)
general or regional anaesthesia.)
The intended benefits :
The intended benefits:
I understand that any procedure
I understand that anyin addition
procedureto those described
in addition on this
to those form will
described ononly
this be
form will only be
Diagnosis and Diagnosis
treatment and
of colonic conditions
treatment of colonic conditions carried out if itcarried
is necessary
out if to save
it is my life to
necessary or save
to prevent
my lifeserious harm toserious
or to prevent my health.
harm to my health.
Serious or frequently
Seriousoccurring risks:occurring risks:
or frequently
I have been told about
I have additional
been procedures
told about which
additional may become
procedures whichnecessary
may becomeduring my
necessary during my
Bleeding, perforation which
Bleeding, may require
perforation hospital
which admission
may require and/or
hospital surgery, and/or surgery,
admission treatment. I have listed below any procedures which I do notwhich
wish to benot
carried
treatment. I have listed below any procedures I do wishout
to be carried out
+/- Formation of+/-
stoma, risk ofofreaction
Formation stoma, to
riskmedication,
of reactionrisk of missed pathology,
to medication, risk of missed pathology, without further discussion.
without further discussion.
+/- Damage to teeth and dental
+/- Damage work.
to teeth and dental work. ........................................................................................................................................................................
........................................................................................................................................................................
Any extra procedures which
Any extra may become
procedures whichnecessary during
may become the procedure:
necessary during the procedure: ........................................................................................................................................................................
........................................................................................................................................................................
√ Blood transfusion - in the event of- bleeding ........................................................................................................................................................................
........................................................................................................................................................................
√ Blood transfusion in the event of bleeding
√ Other procedure
√ - +/- procedure
Other biopsy, +/- -medical photography/video
+/- biopsy, (which may be used
+/- medical photography/video formay
(which teaching
be used for teaching
and research purposes), +/-clip,
and research +/- tattoo,
purposes), +/-Dye
+/-clip, +/-spray, +/-+/-Dye
tattoo, coagulation therapy,
spray, +/-
Patient’s signature
coagulation therapy,
...............................................................................
Patient’s Date .......................................
signature ............................................................................... Date .......................................
+/- lifting solution
+/- lifting solution
Name (PRINT) .........................................................................................
Name (PRINT) .........................................................................................
I have also discussed
I have what the procedure
also discussed is likely
what the to involve,
procedure the to
is likely benefits and
involve, therisks of anyand
benefits available
risks of any available
A witness should sign below
A witness if the
should patient
sign belowisifunable to sign
the patient but hasto
is unable indicated
sign buthis
hasorindicated
her his or her
alternative treatments (including
alternative no treatment)
treatments (including noandtreatment)
any particular
and concerns of thisconcerns
any particular patient.of this patient. consent. Youngconsent.
people /Young
children may /also
people like amay
children parent
alsotolike
sign here (see
a parent to notes).
sign here (see notes).
The following leaflet has been
The following provided
leaflet has :been
...................................................................................
provided: ................................................................................... Patient’s signature ..............................................................................
Patient’s Date .......................................
signature .............................................................................. Date .......................................
The procedureThe
will procedure
involve: will involve: Name (PRINT) ........................................................................................
Name (PRINT) ........................................................................................
general and/ or regional
general andanaesthetic
/ or regional local anaesthetic
anaesthetic sedation
local anaesthetic sedation
Confirmation of consent (To
Confirmation of consent
be completed(To by
be acompleted
health professional
by a healthwhen the
professional when the
Signed .................................................................................... Date .................................................................
Signed .................................................................................... Date .................................................................
patient is admitted foristhe
patient procedure,
admitted if the
for the patient has
procedure, signed
if the the has
patient form in advance)
signed the form in advance)
Name (PRINT) ........................................................................ Job Title .........................................................
Name (PRINT) ........................................................................ Job Title .........................................................
On behalf of the
Onteam treating
behalf of the the
teampatient, I have
treating confirmed
the patient, withconfirmed
I have the patient that
with s/he
the has that s/he has
patient
Contact details
Contact details
(if patient wishes (if to patient
discuss options
wishes to later) .................................................................................
discuss no further questions
options later) ................................................................................. and wishes
no further theand
questions procedure to go
wishes the ahead. to go ahead.
procedure
.Statement of interpreter
.Statement of interpreter
(where appropriate)
(where appropriate) Signature .............................................................................................. Date .......................................
Signature .............................................................................................. Date .......................................
I have interpreted theinterpreted
I have informationtheabove to the patient
information above to the best of my
patient ability
to the bestand in aability
of my way inand in a way in (PRINT) ........................................................................................
Name Job title .................................
Name (PRINT) ........................................................................................ Job title .................................
which I believewhich
s/he can understand.
I believe s/he can understand.
Signed .................................................................................... Date ...........................................................
Signed .................................................................................... Date Important notes:
........................................................... (tick if applicable)
Important notes: (tick if applicable)
Name (PRINT) ........................................................................
Name (PRINT) ........................................................................ See also
advance
Seedirective / living
also advance will (e.g./Jehovah
directive living Witness
will (e.g.
form)
Jehovah Witness form)
Copy accepted by accepted
Copy patient: yes
by /patient:
no (pleaseyes / no (please circle)
circle)
Patient has
withdrawn consent
Patient has withdrawn consent
(ask patient to sign (ask
/ date .....................................................
here) to
patient sign / date here) .....................................................
YELLOW COPY: CASE NOTES
YELLOW WHITE
COPY: CASE COPY: WHITE
NOTES PATIENT
COPY: PATIENT October 2020 October 2020 Medical Illustration, ref: 14/1786
Medical Illustration, ref: 14/1786
10 11Consent – What does this mean? Before any doctor, nurse or therapist examines or treats you they must have your consent or permission. Consent ranges from allowing a doctor to take your blood pressure (rolling up your sleeve and presenting your arm is implied consent) to signing a form saying you agree to the treatment or operation. It is important before giving permission that you understand what you are agreeing to. If you do not understand – ask. More detailed information is available on request. Data Protection Legislation – Privacy Notice Further information on how we look after your personal information can be found on the Trust Information Governance webpage at www.porthosp.nhs.uk - or alternatively, please speak to a member of staff. How to comment on your treatment We aim to provide the best possible service and if you have a question or a concern about your treatment then the Patient Advice and Liaison Service (PALS) are always happy to try to help you get answers you need. You can contact PALS on 0800 917 6039 or E-mail: PHT.pals@porthosp.nhs. uk who will contact the department concerned on your behalf. Author: Nurse Endoscopist LC Produced: 2019 / May 2021 Review: May 2023 Ref: End/27 Medical Illustration ref: 19/5523 (previously 14/0880) © Portsmouth Hospitals NHS Trust Follow us on Twitter @QAHospitalNews www.porthosp.nhs.uk
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